| NPI | 1033179684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES KEITH COFAS Owner/Md 541-882-3818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD25846) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD11585) |
| 363A00000X Physician Assistant (Licence: OR PA01446) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2019-05-16 |